极低出生体重儿不同喂养方式下早期生长发育和并发症的比较  

Comparison of the early growth and development and complications in very low birth weight infants of different feeding status

作　　者：应玲静 曹秀娟[1] 戴玉璇[1] YING Lingjing;CAO Xiujuan;DAI Yuxuan(Department of Neonatology,Jinhua Central Hospital in Zhejiang Province,Jinhua 321000,China)

机构地区：[1]浙江省金华市中心医院新生儿科,金华321000

出　　处：《浙江医学教育》2023年第5期311-315,共5页Zhejiang Medical Education

摘　　要：目的探讨2种不同喂养方式对极低出生体重儿(very low birth weight infant,VLBWI)生后早期(住院期间)生长发育和并发症的影响。方法回顾性分析2020年1月1日至2021年12月31日浙江省金华市中心医院新生儿科收治的90例极低出生体重儿的临床资料,按照住院期间母乳喂养总量占比的不同,将其分为试验组(42例)和对照组(48例)。试验组极低出生体重儿采用强化母乳喂养为主(住院期间母乳喂养总量≥总喂养量的50%);对照组极低出生体重儿采用早产儿配方奶喂养为主(住院期间母乳喂养总量<总喂养量的50%)。比较两组极低出生体重儿生后早期生长发育和并发症发生率的情况。结果试验组与对照组极低出生体重儿住院期间体重增长速率[(15.11±2.97)g/(kg·d)vs.(15.52±3.25)g/(kg·d)]、身长增长速率[(0.92±0.16)cm/w vs.(0.93±0.22)cm/w]、头围增长速率[(0.73±0.18)cm/w vs.(0.76±0.16)cm/w]和出院时宫外生长迟缓的发生率(40.48%vs.37.50%)比较,其差异均无统计学意义(均P>0.05)。两组极低出生体重儿住院期间并发症发生率的比较:喂养不耐受(19.05%vs.39.58%)、坏死性小肠结肠炎(9.52%vs.29.17%)与院内感染(42.86%vs.66.67%),其差异均具有统计学意义(均P<0.05)。结论极低出生体重儿强化母乳喂养有助于降低喂养不耐受、坏死性小肠结肠炎和院内感染的发生,生长速率与早产儿配方奶喂养相当,可以在临床上推广。Objective To investigate the effect of two different feeding status on the early growth and development and complications of very low birth weight infant(VLBWI).Methods This study retrospectively analyzed the clinical data of 90 VLBWI hospitalized in Zhejiang Jinhua Central Hospital from January 1st,2020 to December 31st,2021.According to the different breast milk over the total volume intake during hospitalization,they were divided into the experimental group(breast milk at least 50%of the total volume intake)and the control group(breast milk intake less than 50%of the total volurne intake).The outcomes included the early growth and the incidence of complications during hospitalization were compared.Results The rates of weight gain[(15.11±2.97)g/(kg·d)vs.(15.52±3.25)g/(kg·d)],length growth[(0.92±0.16)cm/w vs.(0.93±0.22)cm/w],head circumference growth[(0.73±0.18)cm/w vs.(0.76±0.16)cm/w]and the incidence of extrauterine growth retardation(40.48%vs.37.50%),there were not statistically significant in both groups(all P>0.05).In terms of the incidence of feeding intolerance(19.05%vs.39.58%),necrotizing enterocolitis(9.52%vs.29.17%)and nosocomial infection(42.86%vs.66.67%)between the experimental group and the control group,there were significant differences(all P<0.05).Conclusions Fortified breastfeeding is more beneficial to very low birth weight infant in reducing the incidence of feeding intolerance,necrotizing enterocolitis and nosocomial infection.The growth rates in very low birth weight infants of two different feeding status are similar.Fortified breastfeeding can be promoted in the clinic.

关 键 词：强化母乳喂养 早产儿配方奶喂养 极低出生体重儿 生长发育 

分 类 号：R722[医药卫生—儿科]